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Hepatitis, Viral, Acute
1995 Case Definition

Hepatitis, Viral, Acute
1995 Case Definition
NOTE: A surveillance case definition is a set of uniform criteria used to define a disease for public health surveillance. Surveillance case definitions enable public health officials to classify and count cases consistently across reporting jurisdictions. Surveillance case definitions are not intended to be used by healthcare providers for making a clinical diagnosis or determining how to meet an individual patient’s health needs.

Clinical Description

An acute illness with a) discrete onset of symptoms and b) jaundice or elevated serum aminotransferase levels.

Laboratory Criteria For Diagnosis

  • Hepatitis A: Immunoglobin M (IgM) antibody to hepatitis A virus (anti-HAV) positive
  • Hepatitis B:
    • IgM antibody to hepatitis B core antigen (anti-HBc) positive (if done) or hepatitis B surface antigen (HBsAg) positive, AND
    • IgM antibody to hepatitis A virus (anti-HAV) negative (if done)
  • Hepatitis C:
    • Serum aminotransferase levels >2 and 1/2 times the upper limit of normal, AND
    • IgM anti-HAV negative, AND
    • IgM anti-HBc negative (if done) or HBsAg negative, AND
    • Antibody to hepatitis C virus (anti-HCV) positive
  • Non-A, Non-B Hepatitis:
    • Serum aminotransferase levels >2 and 1/2 times the upper limit of normal, AND
    • IgM anti-HAV negative, AND
    • IgM anti-HBc negative (if done) or HBsAg-negative, AND
    • Anti-HCV negative or not done
  • Delta Hepatitis*: HBsAg or IgM anti-HBc positive and hepatitis D virus antigen (anti-HDV) positive

Case Classification

Confirmed

A case that meets the clinical case definition and is laboratory confirmed; or for hepatitis A, a case that meets the clinical case definition and occurs among a contact of a person who has a laboratory-confirmed case.

Comments

Do not report cases among persons who have chronic hepatitis or persons identified as HBsAg- or anti-HCV positive as being cases of acute viral hepatitis without evidence of an acute illness compatible with viral hepatitis (with the exception of perinatal hepatitis B virus infection [see Hepatitis, Viral, Perinatal Hepatitis B Virus Infection Acquired in the United States or U.S. Territories]). Furthermore, up to 20% of acute hepatitis C cases will be anti-HCV negative when reported and will be classified as non-A, non-B hepatitis; approximately 10% of cases are anti-HCV negative during the acute phase of illness because of a prolonged interval between onset of disease and seroconversion, and an additional 10% are anti-HCV negative even with prolonged follow-up, because the sensitivity of the antibody assay is only 90%. The only serologic test routinely available for the diagnosis of hepatitis C is total anti-HCV; therefore, excluding other causes of the acute hepatitis is necessary.

* Delta Hepatitis is not a nationally notifiable disease.

Related Case Definition(s)

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Office of Public Health Data, Surveillance, and Technology

National Notifiable Diseases Surveillance System (NNDSS)

NNDSS receives and shares case data from state, local, and territorial health departments to help public health monitor, control, and prevent serious diseases.

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